This year 2017 marked a paradigm shift in pricing policy of coronary stents. In February, the National Pharmaceutical Pricing Authority (NPPA) dramatically cut the prices of coronary stents by up to 85 per cent. This drastic change was enthusiastically welcomed by almost all sections of society, which included common man as well as intervention cardiologists. This radical change seems to rectify the disparities prevailing in stent prices. Coronary stents, which seemed to be out of reach for common man during emergency, were now available at uniform and affordable costs. Similar to any other change in policy, there are some vital concerns regarding this policy also. Multinational companies who spend billions of dollars in getting a new technology, would be skeptical in launching further newer stents in our country with such strict pricing policies. Majority of imported stents are FDA approved which give them clear edge over non FDA approved Indian counterparts. Thus it would be a difficult proposition for Indian industry to compete with Multinationals to achieve a good market share. And in lack of adequate funds for research and development, Indegenous companies may not be able to come up with newer sophisticated technologies.

Regarding bioabsorbale scaffolds also the multinationals sooner or later may develop better-refined versions of BVS, which they may not find suitable for launch in India.

Thus capping of stent prices appears to be a great move prima facies but it has many loopholes. We feel that a special device category should also be made apart from DES or BMS to accommodate newer promising devices.

In month of April, multinational stent companies have already filed for withdrawing their third generation stents from the Indian market. If this happens then our country would remain an end user of only outdated delivery system stents. This would also negatively influence the medical tourism in view of lack of availibility of recent technology in India. There is also an remote possibility of richer Indians to be heading towards west to avail newest medical health facility. This would be a great set back to Indian economy as well.

There should be mind boggling on the vital issues related to this strict pricing policy. Intervention Cardiologists always look for better delivery system for stents, as number of complex angioplasty is on the rise. To tackle a highly tortuous, angulated, calcified lesion you need the best coronary stent delivery system. And everyone agrees that by fixing same prices of all stents you cannot boast that every stent delivery system is equal.

Thus to summarize we can say that pricing cap is an excellent decision, but it needs refining. This has brought nice uniformity across private and public health sector.

To keep our country at progressive path, we need to encourage newer technology in coronary stents also. Thus it is appropriate time to create newer categories for stents to provide niche to promising newer technology.

Our aim should be to reach an optimum point of balance in health care. Every individual should have have affordable treatment for cardiac ailment. And in doing this we should have space for top of line medical technology also for the individuals who can afford it.